Federal and state health regulators have yet to determine whether they will investigate why Texas Health Presbyterian Hospital of Dallas didn’t hospitalize a Liberian man when he first entered its ER last week.

Instead, Thomas Eric Duncan, whose home country is a hot spot for Ebola outbreaks, was released with antibiotics. It was only when he returned to the hospital two days later that he was diagnosed with the often fatal disease – the first such case identified in the U.S.

The Centers for Disease Control and Prevention characterizes Liberia as “active” for Ebola transmission, and it’s among the West African countries hardest hit. Texas Health Presbyterian officials said Tuesday that they were prepared for an Ebola patient. In a news conference, a hospital epidemiologist said the hospital has “had a plan in place for some time now in the event of a patient presenting with possible Ebola.”

But questions now abound about how meticulously caregivers screened Duncan for symptoms and assessed his risk as a Liberian.

“The immediate focus at this time is on managing the situation with this specific patient,” said David Wright, deputy regional administrator for the Centers for Medicare & Medicaid Services, the primary regulator of federally funded hospitals. “We need to let things settle down before determining what, if any, actions we may take.”

A survey of injuries from the West fertilizer plant explosion will be complete in June.

A report on injuries from last year’s fertilizer plant explosion in West will be finished next month, health officials say. A spokeswoman for McLennan County’s public health department said details are still being worked out, but the city of West will get the information first. After a meeting with West officials, the information will be released to the public at large via the health department’s website.

Preliminary figures show about 260 people sought care at hospitals and urgent care clinics after the blast. Health officials in McLennan County and the Texas Department of State Health Services are conducting the survey.

Last month, I wrote this story about what the survey does and doesn’t cover. It focuses on people with immediately apparent physical injuries who went to a hospital or urgent care clinic. But I found that many didn’t go to the hospital and sought care elsewhere.

The survey also doesn’t cover mental health issues common after disasters or follow survivors long-term. Many in West have ongoing health issues.

Public health and policy experts say a thorough survey is needed, now that lawmakers are weighing new safety rules.

An aerial photo taken the day after the West explosion shows the damaged nursing home at lower left and the fertilizer plant at upper right.

The U.S. congressman who represents West has asked Texas’ state health department for a “more comprehensive investigation” of the health effects of last year’s fertilizer plant explosion that killed 15 people.

Rep. Bill Flores, R-Bryan, in a letter his office said was mailed Thursday to the head of Texas’ Department of State Health Services, wrote he was writing as “a concerned citizen.”

“The City of West is now counting on you to provide comprehensive data on the magnitude of injuries that span from mental health issues to physical health problems which can develop over time,” Flores wrote.

The survey focuses only on immediately apparent physical injuries treated at hospitals soon after the blast. It omits people who sought care at private medical practices. It also doesn’t specifically inquire about injuries diagnosed after patients left the hospital, and is not tracking mental health issues.

AUSTIN – What’s the value of Big Data if it flows like molasses to first responders and may be badly outdated?

Those are among the issues that the House Homeland Security and Public Safety Committee confronted at a hearing Monday.

Rep. Joe Pickett, chairman of the Homeland Security and Public Safety Committee

In the year since a fire at the West Fertilizer Co. detonated ammonium nitrate, killing 15 including 12 first responders, legislators have grappled with questions about a database held by the Texas Department of State Health Services.

As required by federal law, businesses with large quantities of any chemical deemed hazardous by the government or its manufacturer must file reports — referred to as Tier II — with the state, local emergency planning committees, and fire departments.

Rep. Joe Pickett, the committee’s chairman, wants to ensure that fire departments get copies of those reports and are trained in how to use them in emergency preparedness.

Apartments destroyed in the West blast (left) and the federal building destroyed in Oklahoma City in 1995 (right).

In Sunday’s paper, I reported preliminary results from a government survey of injuries from last year’s fertilizer plant explosion in West. Among 262 people who went to area hospitals, 53 were classified as having a traumatic brain injury or a concussion.

In combing through research on brain injuries for this story, I came across a study of Oklahoma City bombing survivors who had been diagnosed with traumatic brain injuries. More than a decade after the bombing, a team of researchers from Colorado interviewed 20 TBI patients to see how they had coped. The researchers, from Colorado State University in Fort Collins, published their study in a 2012 issue of the journal Brain Injury.

Only five of those 20 reported receiving specific care or information about their brain injury over the years. But even 10 years later, they were still suffering.

“Many of them are dealing on a daily basis with on-going problems with memory, fatigue, dizziness, confusion, word-finding, concentration, coping with stress, personality changes and so on,” the researchers wrote in a 2012 issue of the journal Brain Injury. “Several participants have experienced marital breakups and/or loss of friendships. Others have had to scale down their employment to positions for which they previously were over-qualified.”

Many of those interviewed underestimated how long they would be dealing with troubles stemming from the bombing. They also wished they had taken offers of financial help early on.

Dallas-area hospitals drew the most fines from Texas state health enforcers last year. The most frequent bullseye: Parkland Memorial Hospital.

The taxpayer-funded institution paid three of the 12 fines levied statewide, totaling $20,000. Parkland was cited for deficiencies in nursing, patient care assessments, and for failing to pay a previous penalty, among other issues.

The fines aren’t necessarily a reliable snapshot of a hospital’s recent performance. The Texas Department of State Health Services often takes months – sometimes more than a year – to bring such penalties.

Parkland’s sanctions, for example, stemmed from problems flagged in 2012, when it was struggling to remedy massive care breakdowns under federal supervision. (Our “Chronic Condition” series examines the roots of those problems.) In 2013, the hospital passed that test – satisfying nearly 500 corrective mandates at a cost that approached $100 million.

Lake Whitney Medical Center, the sole remaining hospital operated by embattled chain owner Dr. Tariq Mahmood, has been mired in turmoil in recent days as employee paychecks bounced, the top administrator left, and the chief of the medical staff stepped down.

At the same time, a team from the Texas Department of State Health Services has been on site investigating quality of care.

The events come on the heels of Gov. Rick Perry’s order just over a week ago to conduct a comprehensive investigation of Mahmood’s operations following my July 14 report chronicling dangers to patients and potential fraud in his hospital system over the last four years. Mahmood is under indictment for insurance billing fraud. He has pleaded not guilty.

Details about what’s happened inside the hospital 30 miles north of Waco are still hazy. The interim manager has not returned my phone call from earlier today, and Whitney’s mayor has not responded to my messages.

State health officials are withholding comment as their investigation continues.

Apartments destroyed in the West blast (left) and the federal building destroyed in Oklahoma City in 1995 (right). File photos.

In Sunday’s paper, I wrote a story comparing how Texas health authorities have responded to the blast in West to how Oklahoma health authorities responded to the 1995 bombing there.

Two days after the Oklahoma City bombing, the state of Oklahoma began tracking injuries related to the blast. The state health commissioner invoked a rule requiring doctors and hospitals to report all related injuries, allowing the state to collect vital information on treatment and safety.

The response of Texas’ state health department, the Texas Department of State Health Services, has been very different following the April 17 explosion of the fertilizer plant in West. State authorities have waited for McLennan County’s health officials to agree to a study, even though no law prevents the state from conducting one on its own.

As a result, the decision to even do a study wasn’t made until late June. It’s still in the planning stages and there is no timeline for when it will get underway. A study documenting injuries could show what’s at stake for the 20,000 other Texans who live close to the state’s 73 other facilities that store large amounts of ammonium nitrate, the chemical that exploded in West.

Government health inspectors are back at Parkland Memorial Hospital today — for at least the third time in recent weeks — as part of their ongoing top-to-bottom survey to determine whether the safety net hospital is finally safe.

As with past visits, federal and state regulators are staying mum about their findings, per standard procedure. So are Parkland officials.

The hospital’s future hinges greatly on whether it can pass the test following nearly two years of work and an estimated $75 million spent on improvements to satisfy hundreds of government mandates. If Parkland fails this inspection phase, it will lose $400 million a year in federal health-care funding critical to its operation.

Proposed abortion restrictions have drawn crowds of protesters and supporters to the Capitol in Austin.

Texas legislators resume debate next week on proposed abortion restrictions. Advocates say they want to protect women and unborn children. Opponents say the restrictions would force all but five of the state’s abortion providers to close, infringing on women’s legal rights and endangering their health. Here is some information to consider when weighing the arguments.

What makes HB2 controversial? Three provisions have attracted the most attention:

Abortion clinics would have to begin meeting the infrastructure requirements of facilities that specialize in outpatient surgeries – so-called ambulatory surgical centers. This would mean major new expenses.

Most abortions would be illegal 20 weeks or more after conception. Proponents say fetuses can feel pain by that point; opponents disagree. The current rule is 24 weeks.

Doctors performing abortions would need permission to admit patients at a hospital within 30 miles, in case the pregnant female experiences complications. Some abortion doctors currently lack hospital privileges.

Have similar measures been enacted elsewhere? About half the states have taken some steps like these, sometimes inspiring legal challenges.

How many ambulatory surgical centers perform abortions? Four reported abortions in 2011, the most recent year for which statistics are available. One abortion clinic in Fort Worth recently converted to a surgical center that performs abortions.

Which abortions would Texas permit after 20 weeks? There are two types: those necessary to save the pregnant female’s life or “major bodily function,” and those “performed on unborn children with severe fetal abnormalities.”